Inside an Absolutely Slammed Abortion Clinic in a Blue State

GRANITE CITY, Illinois — In the hour before the Supreme Court overturned Roe v. Wade, Hope Clinic for Women received 26 calls from potential patients. In the hour afterward, it received 102. By the end of the day, clinic staffers had taken roughly 600 calls.

A week after Roe’s demise, that call number had only slightly dwindled—to about 400 a day, about double what the clinic used to receive. In one clinic staffer’s office, the low cry of the phone was a constant soundtrack to her work.

“We’re quickly learning the area codes for the different places and states,” said the staffer, front desk supervisor Amy Redd-Greiner. “We had someone call yesterday, in Missouri, who was concerned that there is a checkpoint at the Illinois-Missouri border right now.”

There is no checkpoint at the Illinois-Missouri border, which is just minutes away from where the clinic is located. But the fear and confusion over such a possibility, as well as the relentless pleas for help, are what the future of abortion in the United States looks like.

The Mississippi River, which separates Illinois from Missouri, is now the portal between two entirely different realities for people who want abortions. Illinois is one of the safest states for abortion, since the right to the procedure is enshrined in the Democrat-dominated state’s constitution. Missouri, meanwhile, was the first state in the nation to ban abortion once Roe was overturned. Now, abortions are only legal there in cases of medical emergency.

Last week, one health system in Kansas City, Missouri, even temporarily stopped offering rape victims Plan B, out of fear of violating the ban. 

Hope Clinic predominantly serves patients from out of state; the last abortion clinic in Missouri largely stopped performing abortions after state officials tried to shut it down in 2019. Last year, Hope saw patients from 19 states. But now, Illinois is rapidly becoming an island of abortion access within the Midwest, as most states in both that region and the South are set to highly restrict the procedure. 

“I don’t necessarily think that we were not prepared. I just think that, no matter how much we prepared, how this came and played out and how it feels is insurmountable and overwhelming,” said Chelsea Souder, one of Hope’s co-owners. “No matter how much we pull resources together—which is what we are doing, and we’re working with so many partners to make sure as many people can get access—the reality is that’s not going to be the case for every single person.”

As of the Thursday after the decision, anyone who wanted a surgical abortion, which Hope performs up until nearly 24 weeks of pregnancy, would have to wait about two weeks. The clinic was also booked out for three weeks for medication abortions, which Hope will induce, using pills, up until 11 weeks of pregnancy. 

“It’s already hard enough for us to answer phones and say, ‘We have a three-week wait now,’” Souder said. “That’s terrible. Pregnancy is a time-sensitive thing. But I couldn’t imagine saying, ‘We can’t see you at all.’”

On that Thursday morning, around a dozen patients sat in Hope’s waiting room. Receptionists typed frantically behind the front desk, which was enormous, purple, and emblazoned with a cursive sign that read, “Believe in Yourself.” As in many abortion clinics, affirmative posters were everywhere at Hope, blaring slogans like “We Can Do It” and “Attitude is Everything.” Messages about hope, the concept, were especially prevalent at Hope, the clinic; one pillow read, simply, “I am Hope,” above an image of a blooming bud in psychedelic greens and oranges. (Some more pointed messages were confined to the back rooms: One room for staffers featured hand towels with messages for two of the Supreme Court justices who voted to overturn Roe: “Fuck Brett Kavanaugh,” “And Fuck Amy Coney Barrett Too.”)

The patients in the lobby didn’t speak to each other, but instead stared down at their phones. The waiting room was far from quiet, since a radio tuned to a local station was blasting classic rock —“Jessie’s Girl,” “I Love Rock ‘n Roll”—but the silence still felt palpable. One by one, staffers would call out patients’ names. Doors were marked with whiteboards that indicated whether the patient in the room inside was having a surgical or medication abortion. By mid-morning, the rooms were totally full.

“People are—honestly, when they’re here, I think there’s a big sense of relief because, ‘I got here, I’m at my appointment, I have my ultrasound, I’m talking to someone, I’m getting my care,’” said Hanz Dismer, a licensed clinical social worker who was wearing a shirt with a cartoon possum that read, “Yee haw, fuck the law.”

Dismer summarized people’s attitudes in the last week: “‘Oh, my God, I need an abortion and I’m here and I’m stressed and I'm anxious. And thank goodness that I got here, that you guys are here.’”

Dismer is convinced that abortion foes will now try to limit people’s ability to cross state lines for abortions. At a “Life After Roe Symposium,” hosted last month by influential conservative think tank The Heritage Foundation, one attendee floated the idea of prosecuting people who help abortion patients cross state lines. Helping people travel out-of-state for abortions, the attendee said, could be construed as “almost analogous to kidnapping, where if someone took your child out of state, that state would have an interest in that and that would be a federal crime.” 

That attendee works for the Alliance Defending Freedom, a conservative answer to the ACLU that has masterminded much of the legal thinking behind recent high-profile attacks on abortion and LGBTQ+ rights. In all likelihood, such a law would not only not only dramatically curb the rights of pregnant people to travel at all, but legally turn fetuses into people—the ultimate goal of the anti-abortion movement.

“A year ago, I would have said banning interstate travel is going to open a can of worms that the government does not want to deal with,” Dismer said. But now, Dismer thinks every right is under attack. In his concurring opinion to the overturning of Roe, Justice Clarence Thomas said that he wants the court to reevaluate the cases that established the right to same-sex marriage, abolished homophobic sodomy laws, and paved the way for people to have the right to contraception. 

For Dismer, even the 19th Amendment, which granted women the right to vote, is at risk now: If nearly one in four women have abortions, and women start getting prosecuted for getting abortions, they could lose their right to vote as felons. (Although abortion opponents are now insisting that only providers, not patients, would face criminal penalties, abortion patients—particularly those of color—have already been criminalized.) 

Dismer lives in St. Louis, which lies just across the Mississippi River. A few days ago, they recalled, a cop car was patrolling their neighborhood. Right as Dismer was about to pull out of their driveway, the cop seemed to slow down.  

“I froze. I was like, ‘When is this gonna be for me?’ And he just slowed down to make the turn,” Dismer said. “And I knew that that was an overreaction at the time. I was like, ‘I’m not going to get arrested today for providing abortion care, but I don’t know what the state of Missouri will do.’ And we know St. Louis County police are not aligned with left-wing demonstrators.”

Dismer is now weighing whether to move out of Missouri. There isn’t much on the Illinois side of the border; Hope is surrounded by dilapidated industrial buildings and strip malls with only a handful of stores. The most recent movie in the Redbox at the local Walgreens is from 2018. If Dismer leaves St. Louis, there aren’t a lot of nearby cosmopolitan places for them to live.

“I’ve lived in Missouri since I was six weeks old,” they said. “I've lived all across the state. State is beautiful. I love it. Government’s horrible. I hate it. But I would rather be somewhere where I can still serve my community in Missouri and not risk criminalization.”

In a speech after Roe’s overturning, President Joe Biden promised to protect abortion patients’ right to “remain free to travel safely to another state to seek the care they need.” But nobody I talked to at Hope had much faith in the Democrats.

Dismer called the federal government’s response to Roe’s fall “absolutely pathetic.” 

“I am only slightly less angry at the Democrats than I am the Republicans right now, for getting us here and for allowing us to get here,” said Redd-Greiner, clarifying that she was speaking for herself, and not as a representative of Hope. “I have a white hot ball of rage, walking around inside of me.”

Souder pointed out that, as president, Biden could barely bring himself to even say the word “abortion.” 

“We’ve been talking about this for years. And I feel like no one believed that this was coming until it happened,” she said. “I think a lot more could have been done before we got to this point. A lot more. Great, you’re doing things now. You’re trying to protect folks and you’re saying these things. And I’ll love it when I see some action behind it.”

Souder took over Hope just about a month ago alongside fellow co-owner Julie Burkhart, and the pair have been planning to grow the clinic in anticipation of Roe being overturned. They’re trying to hire more staff and keep the clinic open for six days a week, rather than five. They’re building out a family room, where patients can entertain their kids. By mid-July, they plan to offer surgical abortion until the 26th week of pregnancy.

Hope has also partnered with a Planned Parenthood facility in nearby Fairview Heights, the only other abortion clinic in southern Illinois. (Although Planned Parenthood’s name might be synonymous with abortion, independent clinics like Hope provide the majority of procedures in the United States.) Several months ago, the organizations set up a regional logistics center that can help both patients and both clinics sort out details like travel, expenses, and child care.

Legally, abortion is almost as safe as it can be in Illinois. (A framed copy of the law that added abortions right to the Illinois constitution now hangs on the wall in Hope’s lobby, above one of the governor’s pens.) But Illinois’ status as a Midwestern abortion oasis means that, as other states go dark, it will likely only become a more attractive target to anti-abortion activists.

“There’s no reason they're not going to stop because they ban abortion in half the country. That’s not the goal,” Souder said. “The goal is to ban abortion outright. So where do they go next?”

Since Roe was overturned, the number of protesters at Hope has dwindled. In 2019, when I visited the clinic for the first time, a small but committed coterie of protesters ringed the clinic parking lot; this time, as I drove in, there were only three. Two of them lounged in lawn chairs, bearing signs with proclamations about God’s desires and an image of a bloody fetus. The third tried to offer me a bright orange chrysanthemum—until I explained that I was a reporter, not a pregnant woman. 

Normally, Dismer said, protesters show up with vans to try to entice people into them for ultrasounds. But since Roe was overturned, they said, the vans hadn’t made an appearance.

Still, Dismer thinks there will only be more harassment at Hope. Hours before Roe was overturned, the National Abortion Federation released its report tracking violence and harassment against abortion providers in 2021; the report found massive spikes in reports of vandalism, stalking, and assaults and batteries, compared to past years. Burkhart has also been trying to launch an abortion clinic in Casper, Wyoming, but weeks before it was set to open in mid-June, someone set it on fire. Burkhart used to work for George Tiller, a Kansas abortion provider who was shot to death in church in 2009. An obituary for Tiller, clipped from a newspaper, hung on a pegboard in one of Hope’s back rooms.

One of those back rooms is home to Burkhart and Souder’s ad hoc command station, complete with coffee and several laptops. “You can come in and try to burn us down—” Burkhart started to say.

Souder jumped in: “We’re still fucking here.”

Want the best of VICE News straight to your inbox? Sign up here.